Inpatient or outpatient thyroidectomy?

This systematic review and meta-analysis discusses the safety of hemithyroidectomy in an outpatient vis-à-vis an inpatient setting. Thyroidectomy has traditionally been performed as an inpatient procedure. Currently, an increasing number of surgeons are performing thyroidectomy in outpatient settings. The main...

Outcomes for transoral vestibule approach thyroid surgery

Ed’s choice explores a systematic review examining one of the recent innovations in head and neck surgery. It may come as a surprise to some that within a few years of the first published cases of transoral vestibule thyroidectomy, an...

Using evidence and international consensus to guide treatment of thyroid nodules

The authors of this practical review paper highlight a growing issue within thyroid surgery, where high-quality ultrasound has increased the detection of subclinical nodules: what do we do with the patient presenting with an ‘incidental’ thyroid nodule? This has both...

The rise of AI in the head and neck clinic

There has been a huge focus in recent months on the rise of artificial intelligence (AI) in all aspects of modern life, and the head and neck clinic is no exception it appears. This paper builds on previous work to...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Post-thyroidectomy vocal cord palsy: are there long-term sequelae?

This is a well written paper utilising the Hospital Episode Statistics dataset for all thyroidectomies performed in England between 2004 and 2012. The study had a very impressive 43,515 participants and only included young, fit patients undergoing thyroidectomy once for...

A global view of thyroid surgery practices

The incidence of thyroid cancer continues to increase, and both surgery for benign and malignant disease carries an important and persistent incidence of perioperative complications. This paper reports the results of an electronic survey sent to members of seven surgical...

No increase in papillary thyroid cancer during pregnancy

This small study of 19 pregnant patients, who were diagnosed with papillary thyroid cancer before or during the early stages of pregnancy (up to 20 weeks), assessed the changes of thyroid tumours during pregnancy. Conducted at a single centre over...

Previous radiotherapy does not cause worse outcomes in patients with differentiated thyroid cancer

Radiation exposure from nuclear incidents, especially in childhood, is known to increase the risk of thyroid cancer. This large retrospective study from the Memorial Sloan Kettering Cancer Centre sought to determine if thyroid cancers in patients with prior exposure to...

Minimal or not so minimal?

Parathyroidectomy is usually a straightforward technique when the target gland has been accurately determined. Surgical excision is usually through a small midline incision. With the advent of video assisted surgery, trials have been made to use this technique in parathyroidectomy....

Risk of malignancy in non-diagnostic thyroid FNACs

Thyroid nodules are present in between 21-68% of the general population. The evaluation of these nodules to exclude thyroid carcinoma includes fine-needle aspiration cytology (FNAC) and a non-diagnostic cytology result occurs between 8-20% of the time. This retrospective cohort study...

Parathyroid pearls

This article serves to deliver some pearls of wisdom in parathyroid surgery for the ‘low volume parathyroid surgeon’. They have been divided into those relating to the preoperative diagnosis, imaging and localisation techniques and surgical difficulties. Recognised sources of error...

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